Drew Laura B, Drew William E
Oakwood High School, Dayton, OH 04519, and Wright-Patterson Medical Center, Wright Patterson AFB, OH, USA.
Neurocrit Care. 2004;1(3):385-90. doi: 10.1385/NCC:1:3:385.
A common observation in closed head injuries is the contrecoup brain injury. As the in vivo brain is less dense than the cerebrospinal fluid (CSF), one hypothesis explaining this observation is that upon skull impact, the denser CSF moves toward the site of skull impact displacing the brain in the opposite direction, such that the initial impact of the brain parenchyma is at the contrecoup location. A simple model was developed consisting of a balloon filled with water of density 1.00 g/mL enclosed in a clear plastic jar containing salt water of density 1.04 g/mL, simulating the same relative densities of the CSF and brain. The initial movement of the balloon, modeling the brain, was toward the contrecoup location with subsequent movement toward the coup location. The pattern of brain injury in which the contrecoup injury is greater than the coup injury is a result of initial movement of the brain in the contrecoup location. During the process of closed head injury, the brain parenchyma is initially displaced away from the site of skull impact and toward the contrecoup site resulting in the more severe brain contusion.
闭合性颅脑损伤中的一个常见现象是对冲性脑损伤。由于活体大脑的密度低于脑脊液（CSF），一种解释这一现象的假说是，在颅骨受到撞击时，密度较大的脑脊液会朝着颅骨撞击部位移动，从而使大脑向相反方向移位，以至于脑实质的初始撞击点位于对冲部位。构建了一个简单模型，该模型由一个装满密度为1.00 g/mL水的气球组成，该气球置于一个装有密度为1.04 g/mL盐水的透明塑料罐中，模拟脑脊液和大脑相同的相对密度。模拟大脑的气球的初始移动方向是朝着对冲部位，随后朝着撞击部位移动。对冲性损伤大于撞击性损伤的脑损伤模式是大脑在对冲部位初始移动的结果。在闭合性颅脑损伤过程中，脑实质最初会从颅骨撞击部位移位并朝着对冲部位移动，从而导致更严重的脑挫伤。
